Impairment harmonised standard

This harmonised standard is under development following the Inclusive Data Taskforce recommendations to review and update the harmonised standards every 5 years. This is in line with the GSS Harmonisation Workplan.

You can find more information about this in the “Further information” section of this page. If you would like to be involved with this work, please contact us at Harmonisation@statistics.gov.uk.

Policy details

What we mean by harmonisation

Harmonisation is the process of making statistics and data more comparable, consistent and coherent. Harmonised standards set out how to collect and report statistics to ensure comparability across different data collections. This produces more useful statistics and gives users a greater level of understanding about the topic.

What we mean by impairment

This harmonised standard is about impairment, not medical condition.

This means it looks at the functions that a person either cannot perform or has difficulty performing because of their health condition.

For example, glaucoma is a medical condition but being unable to see or being partially sighted is an impairment.

Using this harmonised standard means outcomes for disabled people can be looked at by impairment type.

Questions and response options (inputs)

The harmonised question(s) on this topic are designed to collect basic information, for use in the majority of surveys. They are not designed to replace questions used in specialist surveys where more detailed analysis is required.

There are two versions of the harmonised question on this topic:

1. Standard version: this should be used when a respondent has said “yes”, they have an existing medical condition, using the long-lasting health conditions and illness question.
2. Alternative version: this can be asked to all people, where there is no routing question.

Optional introduction to the question

This optional introduction can be used for clarification. It can be read out or put in explanatory text:

The purpose of this question is to establish the type of impairment(s) you experience currently as a result of your health condition or illness.

In answering this question, you should consider whether you are affected in any of these areas while receiving any treatment or medication or using devices to help you such as a hearing aid for example.

Standard version

Do any of these conditions or illnesses affect you in any of the following areas?

Show card of possible responses and code all the answers that apply:

Code	Impairment
1	Vision (for example blindness or partial sight)
2	Hearing (for example deafness or partial hearing)
3	Mobility (for example walking short distances or climbing stairs)
4	Dexterity (for example lifting and carrying objects, using a keyboard)
5	Learning or understanding or concentrating
6	Memory
7	Mental health
8	Stamina or breathing or fatigue
9	Socially or behaviourally (for example associated with autism spectrum disorder (ASD) which includes Asperger’s, or attention deficit hyperactivity disorder (ADHD))
10	Other (please specify)
Spontaneous only:
11	None of the above
12	Refusal

Note: spontaneous responses should not appear on the show card, but refusals or a response that none of the categories apply should be coded.

Alternative version

Do you have any health conditions or illnesses which affect you in any of the following areas?

Show card of possible responses and code all the answers that apply:

Code	Impairment
1	Vision (for example blindness or partial sight)
2	Hearing (for example deafness or partial hearing)
3	Mobility (for example walking short distances or climbing stairs)
4	Dexterity (for example lifting and carrying objects, using a keyboard)
5	Learning or understanding or concentrating
6	Memory
7	Mental health
8	Stamina or breathing or fatigue
9	Socially or behaviourally (for example associated with autism spectrum disorder (ASD) which includes Asperger’s, or attention deficit hyperactivity disorder (ADHD))
10	Other (please specify)
11	None of the above
Spontaneous only:
12	Refusal

Note: spontaneous responses should not appear on the show card, but refusals or a response that none of the categories apply should be coded.

Types of data collection this standard is suitable for

This question looks at the functions that a person either cannot perform or has difficulty performing because of their health condition. It is for use in social surveys.

The standard can be used for:

• Computer Assisted Personal Interviewing (CAPI)
• Computer Assisted Telephone Interviewing (CATI)

Guidance for data collection

This question is to be asked to respondents aged 16 or over.

This question can be asked by proxy for respondents aged under 16.

If respondents are too ill to respond on their own behalf, proxy respondent from a family member or friend can be recorded. For those not able to speak English, a translator should assist with the data collection.

Guidance can be given on the category response or responses where clarification is requested.

Respondents can select as many responses that apply to them.

Interviewers should steer respondents to using the pre-defined categories wherever possible. They should avoid collecting precise conditions, for example: “Obstructive pulmonary disease” would code to the category “Stamina or breathing or fatigue”.

Publishing high-level impairment groupings

The impairment response options were designed based on how useful they were in helping to develop policy further information can be found in the ‘development of this standard’ section of this page. Although it is not a complete list of impairments, the number of options still means that sample sizes are often too small for analysis.

The Office for Statistics Regulation (OSR) noted in their Review of Transport Accessibility Statistics that “where impairment specific data are collected, they are often not published because sample sizes are too small to provide breakdowns for each of the 10 impairments included in the harmonised standard”. This led to their recommendation that “the GSS Harmonisation Team should develop high level grouping to enable publication of data that represent different experiences – for example high level barrier groupings, and/or high-level impairment groupings”. While we have been working with data users and data processors, we have found the issue of small samples and inability to provide breakdowns is wider than just transport statistics. The same problem exists across both the public and private sectors.

In line with the inclusivity principle of the UK Statistics Authority Strategy, our aim has been to ensure that the groupings were made based on the view of the public. We conducted a card sorting exercise with over 1,000 members of the public to see how they would group the existing response options under the impairment question.  Findings from the card sort demonstrated a high level of agreement for either 3 high-level groupings or 2 high-level groupings. The 3 groups are as follows:

• Physical impairments — which includes “dexterity”, “mobility”, and “stamina”
• Sensory impairments — which includes “hearing” and “vision”
• Mental or cognitive impairments – which includes “memory”, “mental health”, “learning or understanding or concentrating”, or “socially or behaviourally”

To create 2 high-level groups, the physical and sensory impairments can be combined.

We conducted additional analyses to explore if:

• disabled and non-disabled people grouped the impairments differently
• people with an impairment grouped the impairments differently to those who did not have the impairment
• high level categories created groups of equal size
• the majority of respondents have co-occurring impairments that cross the high level groupings

Further information on this approach to grouping impairments and our card sort research can be found in our review of the disability harmonised standards.

We propose these high-level categories based on public understanding of how the impairment options relate to one another. We recommend the use of the groupings to address the issue of sample size being too small to provide breakdowns for each of the 10 impairments included in the harmonised standard. We would welcome feedback on whether these groupings meet the needs of our stakeholders. If you are a user of the standard and would like to provide feedback, please contact us at Harmonisation@statistics.gov.uk.

Using this question in the Welsh language

This harmonised standard was designed in the English language. At present we do not provide a Welsh language translation, because user demand for this standard is UK wide and Welsh language testing has not been completed to ensure a translation is comparable and appropriate. Harmonised standards based on Census research have been tested in the Welsh language, which is why we are able to provide Welsh versions of them. If you are interested in using a Welsh language version of a harmonised standard that has not been translated, please contact us: Harmonisation@statistics.gov.uk.

Comparability

Outputs that come from using this harmonised standard are comparable with other surveys that also use this standard. We would not recommend comparing estimates of impairment from this output with those that do not use this harmonised standard.

Examples of when this standard has been used

Surveys that used this standard

• Family Resources Survey
• Crime Survey for England and Wales
• English Housing Survey
• Health Survey for England

Use in the census

Impairment is not collected in the England, Wales or Northern Ireland Census.

Scotland collects impairment information on their census, but they do not use this harmonised standard. To see the question Scotland use, see question 18 of the Scotland 2022 hosuehold questionnaire.

Development of this standard

A topic group consisting of government departments, academics and external organisations designed the question. Then, various proposals underwent cognitive testing. This testing looked at how respondents react to different versions of the question and checked that the questions correctly capture whether a respondent has a disability according to the Equality Act.

Further information on the development of this standard can be accessed in two Health Statistics Quarterly articles published in Issue 51 in August 2011.

Further information

Alternative questions on impairment

The Washington Group (WG) set are an alternative set of questions that can be used to measure impairment. The WG was set up by the United Nations (UN) Statistical Commission. It developed measures that addressed the lack of internationally comparable measures of disability. The short set of questions asks if a person is able to do certain things, like hear, even if using a hearing aid. It then uses the responses to determine if a person would be classified as disabled.

The output from these questions is not comparable to this harmonised standard. The UK does not use the WG set of questions as they are not consistent with the 2010 Equality Act.

However, the UK does endorse their use as a tool in countries that do not already have valid measures of disability in place.

Inclusive Data Taskforce and GSS Harmonisation Workplan

In October 2020, the National Statistician established the Inclusive Data Taskforce. It was designed to improve the UK’s inclusive data holdings in a broad range of areas. This includes the nine protected characteristics of the Equality Act.

In September 2021 the Taskforce recommendations were published. Some of these recommendations specifically refer to harmonisation.

In response to the recommendations, the Office for National Statistics (ONS) oversaw the publication of an Implementation Plan in January 2022. This gives information about the current and planned initiatives across the UK statistical system. It refers to a GSS Harmonisation workplan, which was published in February 2022. This workplan includes reviewing, refining, and updating harmonised standards.

The workplan sets out activities for this standard in relation to disability. This includes:

• reviewing the topic area
• working with stakeholders and user groups to make sure disability standards meet user needs
• testing possible improvements and changes to the question design for the disability standards

Timescales for this work will be guided by the feedback the team gets throughout the project. We have:

• run research and engagement activities throughout 2022
• published the first findings from our research and engagement work in our review of the disability harmonised standards

We are now working to:

• carry out further research and engagement activities throughout 2023
• design draft questions for updating the disability standards by winter 2023 — this will depend on our research findings and stakeholder engagement activities
• publish updated online self-completion questions by early 2024, followed by telephone mode and face-to-face mode questions

You can find updates on timelines and project activities in the GSS Harmonisation Workplan.

Contact us

We are always interested in hearing from users so we can develop our work. If you would like to be involved with this work or if you use or produce statistics based on this topic, contact us at Harmonisation@statistics.gov.uk.

Updates